MUTNICK A, KIRBY J, BEACH M, JONES RN; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. C2-290.

The JONES Group/JMI Laboratories, N Liberty, IA.

BACKGROUND: CANCER Program was founded (2001) to monitor resistance (R) in anti-microbial and -fungal therapies used for oncology patients. METHODS: More than half of 1,992 isolates from bloodstream, respiratory, urinary and skin infections submitted by 32 oncology centers in NA were Gram-Positives (GP). Several potent GP-focused antmicrobials were tested including investigational fluoroquinolones. RESULTS: S. aureus (SA; n=361, 18.1%), CoNS (282, 14.1%), Enterococcus spp (ESP;197, 9.9%), viridans gr. strept (VGS;n=70, 3.5%) and S. pneumoniae (SPN; n=52, 2.6%) were the top 5 GP pathogens during the initial year. Linezolid (LZD) showed no R among the GP pathogens. With the exception of ESP, vancomycin (VAN) and quinupristin/dalfopristin (Q/D) had complete susceptibility (S) rates. The novel desfluoroquinolone, garenoxicin (GXN) compared favorably to gatifloxacin (GATI) with S rates of 81-90% versus 78%, respectively. VAN (MIC[90,] 1 microg/ml), LZD (2), Q/D (0.5), and teicoplanin (TEI; 1) provided high, near complete S rates (99.7 - 100%) against SA. Versus CoNS (% S, MIC[90] in microg/ml), LZD (100%, 1), VAN (99.6%, 2), Q/D (98.9%, 0.5) and TEI (94.3, 8) were most active. Only LZD (99.5%, 2) provided satisfactory coverage (no R) against the ESP. Each cited agent demonstrated 100% S against VGS and SPN, with the exception of GATI (80% S against VGS). The overall rank order of spectrum was: LZD (100%) > TEI (97) > VAN (96) > GXN (90 at Q/D (88) > GXN (81 at GATI (78). Conclusion: VAN continues to provide acceptable S rates (95.6%) against common GP isolates obtained from the CANCER program patients. Additionally, LZD provides excellent activity (0% R) including ESP strains exhibiting R to glycopeptides. Based on the initial year's results, the use of GATI or GXN in this patient population is possible, but more limited by the elevated risk for R amongst SA, CoNS and ESP.

Publication Types:

• Meeting Abstracts

Keywords:

• Acetamides
• Anti-Infective Agents
• Fluoroquinolones
• Gram-Positive Bacteria
• Humans
• Microbial Sensitivity Tests
• Oxazolidinones
• Research Design
• Vancomycin
• Virginiamycin
• dalfopristin
• drug therapy
• gatifloxacin
• linezolid
• prevention & control
• quinupristin

Other ID:

• GWAIDS0027695

UI: 102267319

From Meeting Abstracts